Healthy Eating for a

Healthy Baby

Congratulations!! You are having a baby. Making healthy choices is even more important now. Eating well and staying active will help you feel good. It will also increase your chances of having a healthy baby.

Best Start and the Nutrition Resource Centre would like to thank the members of the provincial advisory committee for their contribution towards the development of this resource. Written by Nicola Smith, RD Consulting Dietitian

BEST START Ontario’s maternal, newborn & early child development resource centre c/o OPC 180 Dundas Street W., Suite 1900 Toronto, ON M5G 1Z8 1-800-397-9567

NUTRITION RESOURCE CENTRE c/o Ontario Public Health Association 468 Queen Street East, Ste. 202 Toronto, Ontario M5A 1T7 1-800-267-6817

Healthy eating while you are pregnant: ♥ ♥

Many women find it easier to make healthy choices while they are pregnant. Now that ♥ you are eating for two, there are many good reasons to eat in a Guess what? I'm healthy way.

gives your baby the nutrition needed to grow and be healthy reduces your chance of having health problems like low iron or high blood pressure helps you gain a healthy amount of weight ♥ helps you and your family develop healthy eating habits for life

pregnant! I'm so excited but I have so many questions. This booklet One of my biggest questions will answer is what should I eat? many of the questions you may have about healthy eating while you are pregnant. Take your time to read through it. As you go, fill out the quizzes and activities. Try some of the food and recipe ideas. If you have questions or feel like you need extra help, talk to your health care worker. You can also call your local Health Unit or Community Health Centre. Follow along throughout this booklet on our journey to healthy eating for a healthy baby!

© November 2002 Food illustrations used with permission from North Kingston Community Health Centre

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Healthy Eating for a Healthy Baby

Healthy Eating for a Healthy Baby

See how well you do on this healthy eating true and false quiz.

ANSWERS 1.

FALSE. You need some extra food while you are pregnant, but not twice as much. You need to add only 100 calories a day during the first three months and 300 calories a day after that. An extra snack is usually enough. Choose healthy foods such as cheese and crackers, vegetables and dip, fruit or a bean salad.

2.

TRUE. Your need for iron almost doubles when you are pregnant. Iron is used to build healthy blood for you and your baby. If you do not get enough iron you may feel tired and weak. Low iron can also affect your baby's growth. Choose foods that are high in iron such as meat, chicken, beans, and cereal.

3.

FALSE. Yogurt and cheese are also good sources of calcium in our diet. Canada’s Food Guide to Healthy Eating recommends three to four servings of Milk Products while you are pregnant. If you do not like drinking milk, try yogurt and cheese, chocolate milk, fortified soy milk or orange juice with calcium added.

4.

FALSE. There is no need to cut out sugary and salty foods. All foods can fit into a healthy diet. Enjoy a sweet dessert or a salty snack, but remember to balance these foods with healthy choices from Canada's Food Guide to Healthy Eating.

5.

FALSE. A prenatal vitamin-mineral pill cannot replace the benefits of healthy eating. Healthy eating based on Canada's Food Guide is still the best way to meet your nutrient needs. A prenatal vitamin-mineral pill simply helps you get the extra nutrients you need while you are pregnant.

(Check your answers with the answers on the next page)

TRUE

FALSE

1. Now that you are eating for two you need to eat twice as much food

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2. Your need for iron is much higher when you are pregnant

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3. Drinking milk is the only way to get the calcium needed to build

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your baby’s bones 4. You should not eat sugary or salty foods when you are pregnant

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5. Taking a prenatal vitamin-mineral pill can make up for an unbalanced diet

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I have cravings for everything. Sweet or salty, it doesn’t matter. Chocolate covered french fries will do just fine!

Remember, you are eating for two, not like two. Cravings are normal. It is fine to eat some high fat, less healthy foods while you are pregnant. But set some limits. If you eat too many of these foods you may not get the nutrients you and your baby need. You may also gain too much weight.

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How much weight should I gain?

How much weight should I gain?

The recommended weight gain for most mothers is 25 to 35 pounds (11.5 to 16 kg)* *If you were underweight or overweight before you became pregnant or if you are younger than 17, talk to your health care worker about the weight gain that is best for you. If you are pregnant with twins or triplets your health care worker will suggest a healthy amount of weight to gain.

Gaining a healthy amount of weight gives you the best chance of having a healthy baby.

25 - 35 pounds seems like a lot of weight to gain. How will I ever lose it?

Breasts 2 to 3 pounds Blood 4 pounds

You may be surprised that only 5 to 8 pounds of this weight gain is fat. This fat is stored to give you the extra energy you will need while you are pregnant and for breastfeeding. Choosing to breastfeed can help you lose this weight faster. The rest of the weight gain is for the baby, the placenta, blood and fluids. Take a closer look...

Uterus 2 to 3 pounds Extra fluids 2 to 3 pounds Baby 6 to 8 pounds Energy stored as fat 5 to 8 pounds

Placenta and Amniotic fluid 4 to 6 pounds

If you eat well and stay active, you will have no problem gaining a healthy amount of weight. Let your appetite guide the amount of food that you need. Please remember, pregnancy is not a time for dieting. Dieting can harm you and your baby.

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How do your eating habits measure up to Canada's Food Guide to Healthy Eating?

Rate of Weight Gain The rate at which you gain weight is important too. Weight gain is usually slow during the first three months. After this, your baby begins to grow more quickly. At this time, your rate of weight gain should be more rapid but gradual - about 3/4 to 1 pound (0.4 kg) per week. Talk to your health care worker about sudden weight gains or losses. Check your rate of weight gain Record your weight gain on this chart. If your weight gain falls between the two lines you are gaining a healthy amount of weight.

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Do you eat regular meals including breakfast? If you go without food, your baby does too! Try to eat at least every 3 to 4 hours. Breakfast is very important because you have gone all night without anything to eat.

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Do you eat healthy snacks? Choosing healthy snacks is a good way to meet your extra nutrient needs. Try fruit and yogurt smoothies, raisin bran muffins, or a peanut butter and banana sandwich.

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Do you eat 5 to 12 servings of grain products each day?* Choose whole grain breads and cereals, rice, pasta and homemade muffins. These foods give you a source of energy, fibre and iron.

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Do you eat 5 to 10 servings of vegetables and fruit each day?* Eat a variety of vegetables and fruit, salads and juices. Choose colourful vegetables and fruit more often. These foods give you a source of folate, vitamin C and fibre.

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Do you eat 3 to 4 servings of milk products each day?* Drink milk or fortified soy milk. Eat yogurt, cheese and foods made with milk. These foods give you a source of calcium and protein.

Weight Gain

kg/lbs 20/44 19/42 18/40 17/37 16/35 15/33 14/31 13/29 12/26 11/24 10/22 9/20 8/18 7/15 6/13 5/11 4/9 3/7 2/4 1/2 0/0 -1/-2 -2/-4

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Do you eat 2 to 3 servings of meat and alternatives each day?* Choose meat, chicken and fish or alternatives like eggs, peanut butter, tofu, beans and lentils. These foods give you a source of iron and protein.

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Do you eat small amounts of ‘other’ foods?* Taste and enjoyment can also come from other foods and drinks that are not part of the food groups. Sweets, high fat snack foods and soft drinks can be enjoyed in small amounts. * complete the food diary on page 17 to find out how many servings you eat.

-3/-6 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

Number of Weeks Pregnant 8

Let's see... Do I have a balanced meal? Grains, vegetables, milk, meat and chocolate?!

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This is, in fact, a balanced meal. It includes all four food groups from Canada's Food Guide to Healthy Eating. A small piece of chocolate cake can fit as part of a balanced meal.

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Building Blocks for a Healthy Baby Your growing baby depends on you to eat the foods that are their building blocks for a strong body and healthy mind. The key building blocks for a healthy baby are: Carbohydrates... from grain products Folate & Vitamins... from vegetables & fruit

Calcium... from milk products Iron... from meat and alternatives

1 slice of bread 1 small roll 1/2 bagel or big bun 4 to 6 crackers 1/2 cup cooked rice or pasta 3/4 cup hot or cold cereal 1 medium size vegetable or fruit 1/2 cup fresh, frozen or canned vegetables/ fruit 1 cup salad 1/2 cup vegetable or fruit juice 1 cup milk 1 cup chocolate milk 3/4 cup yogurt 50 grams cheese (size of your thumb) 2 slices processed cheese 50 to 100 grams meat (size of a deck of cards) 1/2 to 1 cup beans or lentils 1 to 2 eggs 1/2 cup tofu 2 tablespoons peanut butter

Eat foods from all four food groups and take a prenatal vitamin everyday.

Adapted with permission from the Haldimand-Norfolk Health Unit

While you are pregnant or breastfeeding baby shares the food you eat. It is important for you to choose foods from Canada’s Food Guide so your body is healthy for you and your baby.

Choose a variety of foods. Different foods give your body the building blocks needed to grow a healthy baby.

and Healthy Moms Eating Well for Two (CPNP)

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Baby Building Nutrients

Folate (Folic Acid)

Calcium and Vitamin D

Folate is a vitamin that helps build healthy blood and tissues for you and your baby.

Calcium and Vitamin D work together to build strong bones and teeth for your baby. These nutrients also help keep your bones strong.

♥ Choose romaine lettuce or spinach for your salads. Sprinkle salads with sunflower seeds ♥ Top cereal with your favourite berries ♥ Try lentil or bean soup for lunch

♥ Drink milk* or chocolate milk* with your meals. If you are not a milk drinker, try fortified soy milk*

♥ Choose orange juice more often

♥ Make a stir-fry with calcium-set tofu, bok choy, kale and broccoli

♥ Have vegetables such as broccoli, peas, Brussels sprouts and corn more often

♥ Try cheese and sardines* on a cracker for a snack

Taking a prenatal vitamin-mineral pill that has at least 0.4mg of folic acid is especially important before you become pregnant and during the first few weeks of pregnancy. Folic acid can help reduce the risk of neural tube defects (NTDs). NTDs are birth defects that affect the baby’s brain and spine, such as spina bifida.

♥ Include yogurt and calcium-added orange juice as part of your breakfast ♥ Enjoy a little sunshine! Your skin makes vitamin D from the sun

Fruit & Yogurt Smoothie In a blender, mix 1/2 cup fresh or frozen berries with 1/2 banana, 1/2 cup yogurt and 1/2 cup milk or soy milk.

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Essential Fatty Acids Certain types of fats, called essential fatty acids help your baby's brain grow.

♥ Enjoy pasta with meat and tomato sauce

♥ Use salad dressing made from oils such as canola or soybean oil

♥ Drink a glass of orange juice with ironenriched breakfast cereals

♥ Use vegetable oils or soft margarines in cooking and baking

♥ Choose dried fruits such as raisins, prunes and dried apricots for a snack

♥ Have salmon for supper or a salmon sandwich for lunch

♥ Make chicken fajitas with red and green peppers and mango-black bean salsa ♥ Enjoy bean dishes more often like chili, bean burritos or pea soup

Herbed Oil & Vinegar Dressing In a small bowl, whisk together: 1/4 cup canola oil 2 tbsp vinegar 1 tsp Dijon mustard

Mango Black Bean Salsa

1/2 tsp garlic powder

Mix together: 1 can black beans 1 diced mango 1/2 cup diced red onion 1/4 cup lemon juice 2 tbsp vegetable oil. Toss with 1/4 cup chopped cilantro if you wish. Chill for one hour before serving.

1 tsp dried basil. Add salt and pepper to taste Serve over green salads, pasta salads or use as a marinade for vegetables. I am already eating well. Do I need to take a prenatal vitamin-mineral pill?

This recipe is a good source of essential fatty acids

This recipe is a good source

This recipe is a good source of calcium and vitamin D

This recipe is a good source of folate and vitamin C

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Iron Iron helps build healthy blood for you and your baby. Foods high in vitamin C help your body absorb iron better.

* These foods have both calcium and vitamin D

Baby Building Fruit Salad

Mix together: 1/2 a cantaloupe, diced 1/2 a honeydew melon, diced 1 banana, sliced 1 grapefruit, peeled and diced 2 oranges, peeled and diced Stir in one cup of calcium-added orange juice. Top with yogurt or ice cream

Baby Building Nutrients

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Healthy eating is the best way to get all the nutrients that you and your baby needs. But nobody is a perfect eater. A prenatal vitamin-mineral pill helps you get the extra vitamins and minerals you need while you are pregnant and breast-

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Use with Caution

How much caffeine is safe during pregnancy? Caffeine is passed on to your baby through the placenta. To keep your baby safe, drink no more than three 8oz (250ml) cups of coffee or tea and limit the amount of cola that you drink. Are herbal teas safe to drink while I am pregnant? Be careful if you use herbal teas. Some herbal teas can be harmful to you or your baby. Choose from the list of “safe” herbal teas below. Drink no more than 2 cups per day. It is also a good idea to choose different herbal teas. Don't drink the same one every day.

How much alcohol is too much? Any amount of alcohol is too much when you are pregnant. Alcohol is quickly passed on to your baby through the placenta. The brain and nervous system of your baby can be harmed by alcohol. This can lead to life-long problems known as fetal alcohol syndrome (FAS) or fetal alcohol effects (FAE). If you drink alcohol while you are pregnant, stop. If you can't, get help. Talk to your doctor, No coffee, tea, midwife or alcohol or diet drinks. counselor. What can I drink?

(No more than 2 cups a day)

I've heard that pregnant women should not eat some kinds of fish. Is this true? Some types of fish such as shark, swordfish and tuna steaks have high levels of mercury. High levels of mercury can harm your growing baby. Do not eat these types of fish more than once a month. Larger and older lake fish, like trout and walleye, may have high levels of mercury. Limit the amount that you eat. Other fish, including canned tuna are safe to eat more often.

Food poisoning can be very dangerous when you are pregnant. Listeriosis and toxoplasmosis are types of food poisoning that can seriously harm your baby.

Citrus peel Ginger Lemon balm Linden flower Orange peel Rose hip

To reduce your risk of food poisoning, follow these tips: ♥ ♥ ♥ ♥ ♥

You can still enjoy small amounts of coffee, tea, safe herbal teas and diet drinks while you are pregnant. Just avoid alcohol. There are plenty of healthier choices too. Choose milk, chocolate milk, fruit or vegetable juices, lemonade and fruit spritzers (fruit juice mixed with soda

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Will artificial sweeteners harm my baby? Nutrasweet (aspartame), Splenda (sucralose) and other artificial sweeteners allowed in foods in Canada will not harm your baby. Even so, it is a good idea to choose small amounts of foods and drinks made with artificial sweeteners. Diet drinks and diet foods offer little or no nutritional value.

Protect yourself and your baby from FOOD POISONING

Safe Herbal Teas

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Wash your hands often Wash raw vegetables and fruit well Make sure meat, poultry, fish and hot dogs are well cooked Follow "best before" dates Ask someone else to change the cat litter box

Some foods can increase your risk of food poisoning: ♥ Avoid unpasteurized milk and cheeses such as Brie and Camembert ♥ Avoid unpasteurized apple ciders ♥ Avoid patés and smoked fish products

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Here is a sample food diary for one day: Grain Products

Vegetables and Fruit

Milk Products

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My Food Diary Meat & Alternatives

Other Foods

Breakfast Fruit and Yogurt Smoothie* 2 slices whole wheat toast 2 tbsp peanut butter

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Grain Products

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Snack Bran muffin 1 cup orange juice

Choose one day to complete your own food diary. Write down everything you had to eat and drink that day. Count up the number of servings you ate from each food group. How did you do compared to Canada's Food Guide to Healthy Eating? Vegetables and Fruit

Milk Products

Meat & Alternatives

Other Foods

Breakfast

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Lunch Vegetable Cheese Quesadillas* 1/2 cup carrot sticks 1 cup chocolate milk

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Snack

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Snack

Lunch

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1 cup fruit salad* Supper Fast & Easy Chicken Cacciatore* 1 cup egg noodles 1 cup milk Butter tart

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Snack

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Popcorn Gingerale TOTALS

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8

4

2

3 Snack

*Recipes can be found in this booklet.

This food diary includes the right amount of foods from all the food groups. It also has many baby-building foods like orange juice, milk, vegetables and chicken. ‘Other foods’ that are not part of the four food groups are used in small amounts to add flavour and enjoyment to this menu.

Grain Products One serving is 1 slice of bread; 1 small roll; 1/2 bagel or big bun; 4 to 6 crackers; 1/2 cup cooked rice or pasta; 3/4 cup hot or cold cereal

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Vegetables & Fruit One serving is 1 medium size vegetable or fruit; 1/2 cup fresh, frozen or canned vegetables or fruit; 1 cup salad; 1/2 cup vegetable or fruit juice.

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TOTALS

Milk Products

Meat & Alternatives

One serving is 1 cup milk; 1 cup chocolate milk; 3/4 cup yogurt; 50 grams cheese (the size of your thumb); 2 slices processed cheese.

One serving is 50 to 100 grams meat, poultry or fish (the size of a deck of cards); 1/2 to 1 cup beans or lentils; 1 to 2 eggs; 1/2 cup tofu; 2 tbsp peanut butter.

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I Don’t Feel So Well

I Don’t Feel So Well

Nausea and Vomiting

Constipation

Many pregnant women feel sick from time to time, especially in the first few months of pregnancy. It may be the changes in your hormone levels that cause you to feel sick. Try these ideas to help you feel better:

Hormone changes and pressure of the baby against your bowel can cause constipation. Eating high fibre foods and drinking plenty of fluids can help.

♥ Eat several small meals each day rather than three large meals. Try not to skip meals. You will feel worse if your stomach is empty ♥ Try eating crackers, bread or dry cereal before getting out of bed in the morning ♥ Get out of bed slowly in the morning ♥ Have a snack before bedtime ♥ Drink fluids before or after meals. Do not drink them with meals ♥ Avoid coffee, fatty foods and foods with strong smells or tastes

I'm over the nausea but now I have heartburn. It is really bad at night.

Try these ideas to help you feel better: ♥ Start the day with a whole grain cereal ♥ Choose whole grain breads ♥ Aim for 5 to 10 servings of vegetables and fruit each day ♥ Drink 8 to 12 cups of fluid every day. Water, milk, juice and other caffeine-free beverages count ♥ Be physically active

Talk to your health care worker if you cannot stop vomiting or if you feel too sick to eat at all.

Heartburn In the second half of pregnancy, many women get heartburn. Heartburn happens because of the pressure of the baby against your stomach. Try these ideas to help you feel better: ♥ Eat several small meals each day rather than three large meals ♥ Drink fluids before or after meals. Do not drink them with meals ♥ Do not lie down for at least one to two hours after eating ♥ Avoid foods that cause you to get heartburn. Be careful with spicy foods, high fat foods and coffee

Do not take laxatives without talking to your health care worker. Some laxatives are not safe to take while you are pregnant.

Gestational Diabetes Some women develop diabetes when they are pregnant. Diabetes means blood sugar levels are too high. High blood sugar can harm you and your baby. If you have any risk factors, your health care worker will test for diabetes when you are about 26 weeks pregnant. Ask your health care worker if you should have this test. You have a greater chance of developing gestational diabetes if: ♥ ♥ ♥ ♥ ♥

you you you you you

are overweight have a family history of diabetes are Aboriginal, Asian, Hispanic or African have had a baby over nine pounds have gained a lot of weight while you have been pregnant

Do not take antacids without talking to your health care worker.

Almost half of pregnant women get heartburn. Eating smaller, lower-fat meals more often may help. Not eating before bedtime is also a good idea. Some women find raising the head of their bed with blocks under the legs of the bed helps prevent heartburn at night. 18

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If you develop diabetes, you should meet with a dietitian. A dietitian can help you make changes to your diet that will lower your blood sugar levels. The good news is that pregnancy-related diabetes almost always goes away after you have your baby.

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Should I be physically active while I am pregnant? Staying active while you are pregnant has many benefits. Active living can: • help make labour and delivery easier • help you recover more quickly after your baby is born • help prevent constipation • help you gain a healthy amount of weight • give you more energy

One month to go and I'm still out walking. I just take it easy and make sure I don't go too far.

Ask your local Health Unit or Community Heath Centre for a copy of Canada’s Physical Activity Guide. This guide can help you make wise choices about physical activity. You can also see the guide online on the Health Canada website: www.hc-sc.gc.ca Click on “Healthy Living”.

You can be active throughout your pregnancy. Keep these tips in mind: • Choose safe activities like walking, low impact aerobics, swimming or water aerobics • Talk to your doctor about your plans to be active • Do not exercise when it is very hot or humid • Drink plenty of fluids

Vegetable Cheese Quesadillas 1/2 red or green pepper, diced 1 cup chopped fresh spinach 1 diced tomato 2 large flour tortillas 3/4 cup shredded Cheddar cheese

Fast and Easy Chicken Cacciatore 1 28oz can diced tomatoes 2 cups mushrooms, sliced 4 skinless chicken pieces 1 green pepper, diced

1. In a large saucepan, combine 1. Heat a nonstick pan on the stove undrained tomatoes with over medium heat. Add peppers, mushrooms. Bring to a boil. spinach and tomatoes. Cook and 2. Add chicken pieces. Cover and stir for 1 minute. Put vegetable simmer over low heat for 30 minmixture on a plate. utes. Turn the chicken over and 2. Place one tortilla in the pan. add the green pepper. Continue Spoon cooked vegetables onto the cooking for 10 minutes. tortilla. Sprinkle with cheese. 3. Remove the chicken. Boil sauce, Top with the second tortilla. uncovered until thickened. 3. Heat 2 to 3 minutes or until Pour over the chicken. cheese begins to melt. Flip and Makes 4 servings cook for another 2 to 3 minutes. Remove from pan and cut into wedges. Meet my new baby! Makes 4 servings She is an 8 pound, 2 ounce, Serve with sour healthy baby girl. Healthy eating turned out to be pretty easy. It sure was worth it!

SPECIAL NOTE Do not begin a new exercise program during the first 14 weeks of your pregnancy or after your 28th week.

Regular exercise can help you feel better while you are pregnant. Choose safe activities like walking or swimming. If you have any problems, stop exercising and talk to your health care worker right away.

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Congratulations! During your nine month journey, you too may find that healthy eating is easy. You don’t have to eat tasteless meals or give up your favourite foods. There are many ways to enjoy eating. Continue to make healthy choices after you have your baby. Healthy eating gives you the energy you need for breastfeeding and raising a healthy family.

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Notes

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Should I get extra nutrition help?

1.

Are you younger than 17 or older than 35?

2.

Were you underweight or overweight before you became pregnant?

3.

Do you often diet to lose weight?

4.

Are you pregnant with twins or triplets?

5.

Are you having trouble eating because of nausea or vomiting?

6.

Are you a vegetarian who does not eat eggs or milk products?

7.

Are you gaining too little or too much weight?

8.

Is it hard for you to drink milk or eat yogurt or cheese?

9.

Do you have a condition that requires a special diet?

YES

NO

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(eg. Food allergies, diabetes, digestive problems) 10. Have you been pregnant within the last two years?

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If you answered YES to one or more these questions, it is a good idea to meet with a dietitian. Ask your health care worker to refer you to a dietitian. You can also call your local Public Health Unit or Community Health Centre to find a dietitian in your area.

Where to go for more information on healthy eating for a healthy baby: Your local Public Health Unit Your local Community Health Centre Your local Canada Prenatal Nutrition Program Health Canada website: www.hc-sc.gc.ca Click on “Just for You”

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